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Full Mouth Debridement

I am a new graduate and I am having difficulty finding a hygiene position. I have been to several interviews and at least 3 of the offices have told me I would be expected to perform a full mouth debridement. Based on my professional opinion, I explain what research shows and politely express that I am not comfortable doing this. How would you handle this situation and what would you say?



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5 Answers

Why do you feel so strongly about debridements? I’m just curious, and what do you do when there is so much calculus that an accurate periodontal evaluation & comp exam is impossible?

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While not very often I do preform FMD. I find it especially useful on patients who have not been to the dentist in many years and will probably end up not needing SCRP. I do FMD then a fine scale in 2 weeks, where I re-eval for SCRP. On many of these I find the pt just needs to get back on track and isn’t necessarily a perio pt that ends up requiring SCRP. If they do need SCRP then I encourage pt to schedule for this asap (usually only spot scaling is indicated at this point). Not trying to talk you into the procedure I just feel like there are certain instances where it can be good. I do understand where it can be harmful, its definitely a judgment call and overuse of this code can cause more harm than good. I just personally don’t feel like FMD is a black and white issue. That being said I would not want to work in an office that expected that code to be in regular use. Maybe ask the offices to be more clear on how often they use the code in their office. I generally use it only a handful of time a year.

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We do not do FMD often, but if you have a patient who has so much calculus that you cannot see tooth surfaces, then it must be done. A comp exam cannot be done at that visit, as the purpose of FMD is to be able to do a comp exam. We do not do a perio chart until the follow up fine scale either-that way those who just needed to “get back on track” do and those who still need SRP get scheduled for it.

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If you feel strongly about not doing FMD, then be patient and eventually you’ll find the right office for you. That’s all you can really do, I guess! Good luck! 🙂

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Debridements can cause perio infections. If there is bone loss, BOP and heavy calculus that can be seen both demographically and clinically, then SRP can be diagnosed. The hard tissue exam can be completed post scaling.
In my experience, debridements have been used as a “practice builder” since insurance companies will pay for them but they can do the patient more harm than good.
To the OP, I say stick to what you have learned and the right job will come up…maybe telling can get your foot in the door somewhere.

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